| Boost Counseling Services, Pllc | |
|
3045 N 1st Ave Ste A Tucson AZ 85719-2560 | |
| (520) 548-8974 | |
| Not Available |
| Full Name | Boost Counseling Services, Pllc |
|---|---|
| Speciality | Counselor |
| Location | 3045 N 1st Ave Ste A, Tucson, Arizona |
| Authorized Official Name and Position | Liana Joy Condello (MEMBER) |
| Authorized Official Contact | 5205488974 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Boost Counseling Services, Pllc Po Box 36144 Tucson AZ 85740-6144 Ph: (520) 548-8974 | Boost Counseling Services, Pllc 3045 N 1st Ave Ste A Tucson AZ 85719-2560 Ph: (520) 548-8974 |
| NPI Number | 1891338547 |
|---|---|
| Provider Enumeration Date | 10/25/2019 |
| Last Update Date | 11/05/2019 |
| Medicare PECOS PAC ID | 2365963782 |
|---|---|
| Medicare Enrollment ID | O20250301000137 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1891338547 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YA0400X | Counselor - Addiction (substance Use Disorder) | (* (Not Available)) | Primary |
| Provider Name | Liana Joy Condello |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1770597114 PECOS PAC ID: 3274054697 Enrollment ID: I20250301000140 |
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